The modern battlefield is dynamic, interconnected and unforgiving. American dominance in any domain—land, air, sea, space and cyberspace—is no longer assured as America’s adversaries continue to become more agile and the threats increasingly more complex. The need to achieve convergence across multiple domains and all warfighting functions has never been more urgent.
Army Medicine, as part of the sustainment and protection warfighting functions, is often mistakenly perceived as a standalone combat service-support function. Failing to understand Army Medicine’s critical role is a direct threat to ensuring the operational readiness of the force, sustaining available combat power, overcoming contested logistics and ensuring the endurance of maneuver forces.
Integration of medical sensors, data aggregation, analysis and decision support tools into the Combined Joint All-Domain Command and Control (CJADC2) system is essential to building a resilient, adaptable force ready to meet the challenges of modern warfare.
Failing to incorporate the full visualization and integration of the Army’s medical commodities into a unified CJADC2 system will result in commanders making decisions with an incomplete understanding of the battlefield due to the lack of critical information. Army Medicine has taken the initial steps to unify medical data in emerging Army systems and provide the data architecture that supports commanders’ medical view of the battlefield.
The conflict between Ukraine and Russia offers a contemporary example of why fully integrated command and control is critical. Ukraine’s ability to counter Russian advances has hinged on its coordination with partner nations and its integration of intelligence, logistics and battlefield operations. By leveraging real-time data shared across coalition networks, Ukraine has been able to maximize the effectiveness of limited resources, rapidly reposition forces and respond to evolving threats.
This level of synchronization enables and demonstrates the value of combined arms and joint all-domain operations. The lesson for the U.S. Army and its allies and partners is clear: success on future battlefields will depend on the seamless integration across all warfighting functions, with Army Medicine fully represented.
As the conflict in Ukraine demonstrates, the Army Health System involves more than just treating casualties, but rather informs and enables a commander’s ability to maneuver, protect and sustain formations in contested environments.
Medical Resources
When integrated into CJADC2, critical medical data is collected, aggregated and analyzed to provide commanders near real-time visibility into medical resources, evacuation capabilities and casualty data. This information enables better decisions at every level of command. For example, in a contested environment, a commander could adjust operational plans to secure evacuation routes while minimizing risk to forces. Simultaneously, sustainment planners could optimize supply routes to ensure medical resources reach the point of need without compromising broader logistical priorities.
The conflict in Ukraine also underscores the importance of speed and accuracy in medical and logistical decisions. Delayed casualty evacuations or supply chain disruptions can have cascading effects, degrading combat power and morale.
Current command-and-control systems exhibit a notable lack of medical data. At echelon, unit leaders often convey medical information using separate systems or have to manually enter data into the primary command-and-control system, often referred to as the “swivel chair” approach. Without full integration of medical data and systems, commanders often lack real-time visibility of the medical information layer in their command-and-control architecture. This reduces their understanding of the medical “magazine depth” on the battlefield, or how medical capabilities and requirements impact the fight across warfighting functions.
Consistent with the objectives of the Army Transformation Initiative, Army Medicine must seek opportunities to utilize currently fielded command-and-control systems in simulated and/or real-world scenarios to identify risks and provide feedback to industry providers. As new tactics and systems become available, Army leaders must incorporate them into formations to allow end-users to provide feedback to further inform the acquisition process. Army Medicine must adopt a “fail fast, fix fast” approach to shorten the time between initial development and full fielding of new command-and-control systems. These testing environments must span tactical and operational levels to include the combat training centers, division and corps warfighter exercises and the Army service component commands, allowing soldiers to optimize systems across the conflict continuum.
Fully Synchronized
By integrating Army Medicine into CJADC2, the Army ensures its medical operations are not reactive and siloed but rather proactive and fully synchronized with combat operations. This approach leverages the full spectrum of data analytics (descriptive, diagnostic, predictive, prescriptive and cognitive) to enhance survivability, preserve combat power and preserve freedom of maneuver. This proactive posture will give commanders enhanced visibility, allowing them to seize and maintain the initiative against adversaries.
Achieving this level of integration requires more than simple technological solutions—it demands collaboration, innovation and cultural change. Army Medicine cannot achieve its goals in isolation. To align its modernization efforts, Army Medicine must collaborate across the Army command structure (including major commands, Army service component commands and direct reporting units), the sustainment community and remaining warfighting functions. This collaboration ensures technology, training and doctrine investments are fully integrated across the force.
Systems like the Military Health System’s GENESIS platform must be adapted to work seamlessly within CJADC2, enabling data sharing in permissive and degraded or contested environments. Leaders and soldiers must become data literate and trained to operate effectively in a data-rich, data-driven, multidomain framework, where medical commodities are seen as integral components to mission success.
A critical aspect of integration is system conception and design. From the outset, Army Medicine must understand the available networks and systems across the depth of the battlefield and design applications that integrate into those networks. At the forward edge, networks may have significant constraints and limitations to ensure the security and protection of forward forces. Medical technologies and applications must integrate into those networks and adhere to the electronic signature rules of the operating environment. Fundamentally, this is a paradigm shift regarding design and integration and requires Army Medicine to integrate from initial concept to fielding and throughout the system’s life cycle.
Army Medicine is aligning essential medical data within the Army data environment, recognizing that a truly integrated battlefield requires a holistic view of medical readiness and capabilities. The effort includes not only connecting existing databases but ensures the interoperability and standardization of data formats. Key efforts include relevant extracts from the Military Health System’s Electronic Health Record, essential medical readiness data from systems of record and equipment readiness from enterprise systems. This integration is guided by a common data model, enabling seamless information sharing and analysis across echelons and across roles of care, fostering a more complete operational picture for commanders.
Mapping Capabilities
To achieve this visualization, Army Medicine is constructing distinct data layers specifically designed to describe the roles of medical care across the spectrum of conflict. Informed by the principles of the Army Medicine Decision Advantage Strategy, these layers map current capabilities and have the potential to enable future patient flows, coordinate patient movement and inform logistical and personnel requirements across the battlefield.
This geospatial and functional depiction of medical assets allows for proactive resource allocation, predictive analysis of medical needs based on evolving battlefield dynamics and, ultimately, optimized casualty management. By visualizing these data layers within the unified Army data environment, commanders gain a significantly enhanced ability to anticipate, respond to and mitigate medical challenges, directly contributing to mission success and force preservation.
A question often arises: How can Army Medicine balance the need for new investments with existing resource constraints? The answer lies in reprioritization. Programs and systems that no longer meet the demands of modern warfare must be retired, with resources redirected toward scalable, interoperable solutions. As the Defense Health Agency assumes responsibility for specific medical programs, Army Medicine must focus on enhancing its capabilities in multidomain operations. This approach optimizes resources and strengthens interoperability across the joint force as well as with allies and partners.
Data analytics, artificial intelligence and machine learning will play a crucial role in this transformation. By analyzing patterns in casualty rates, medical supply consumption and evacuation timelines, Army Medicine can proactively anticipate needs and position resources, enhancing maneuver. Pilot programs within select units are already testing these capabilities, providing valuable insights for scalable rollouts. These innovations and investments in resilient communications networks ensure that Army Medicine remains operationally effective even in the most contested environments.
Integrating Army Medicine into CJADC2 is more than solving medical challenges. It is about integrating medical support to optimize the Army’s ability to fight and win. Medical readiness enhances force protection by ensuring soldiers are fit to fight and more apt to recover quickly. Using real-time casualty data informs maneuver commander decisions, ensuring that evacuation and protection considerations are part of every operational plan. Data analytics can streamline supply chains, reduce waste and ensure resources are available where needed most. These capabilities contribute to a unified force prepared for tomorrow’s battlefield complexities.
Prioritize Integration
A stark reminder of what is at stake is on display in Ukraine. Even the most advanced forces can struggle to adapt to a determined adversary without coordinated command and control. For the U.S. Army, integrating medical data into CJADC2 is not just an enhancement but a necessity. It ensures medical-support operations no longer are treated as secondary considerations but are embedded into every facet of mission planning and execution.
Leaders across all branches and specialties must prioritize this integration. The future battlefield will not allow for silos or fragmentation. Victory depends on unified action, shared innovation and a commitment to building an adaptable, resilient force capable of operating across all domains.
Army Medicine, working alongside Army stakeholders, allies and partners, is working to ensure the Army remains the most capable and dominant land force, a requirement in multidomain operations. As outlined above, the first steps are underway to depict medical information in command-and-control systems.
In this effort, Army Medicine is not merely a support function, it is a solution. By aligning its resources, collaborating across warfighting functions and embracing innovation, it demonstrates its value to the joint force, as well as interagency, intergovernmental and multinational partners.
Brig. Gen. Jonathan “Craig” Taylor and Col. William Bimson contributed to this article.
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Lt. Gen. Mary Izaguirre is the 46th surgeon general of the U.S. Army and the commanding general of U.S. Army Medical Command, Joint Base San Antonio-Fort Sam Houston. Previously, she served as commanding general of U.S. Army Medical Readiness Command, East. She deployed multiple times to Iraq and Afghanistan. She is a doctor of osteopathic medicine who is board-certified in family medicine and is a Fellow of the American Academy of Family Physicians. She has three master’s degrees: one in public health from the University of Washington; one in military arts and science from the U.S. Army Command and General Staff College; and the third in national security and resource strategy from the Eisenhower School for National Security and Resource Strategy.
Brig. Gen. Bill Soliz is the 21st chief of the Army Medical Specialist Corps and the J-3/5/7 of the Defense Health Agency, Falls Church, Virginia. Previously, he served as commanding general, Medical Readiness Command, Pacific and director of the Defense Health Network Indo-Pacific, Honolulu. He has multiple deployments with both conventional and special operations. He is a physician associate who is board-certified and is a Fellow of the American College of Healthcare Executives. He holds a doctorate in medical science, a Master of Business Administration, a master’s in family medicine and is a graduate of the Joint and Combined Warfighting School.